General Measures
- Sun Protection: Use high SPF sunscreen and wear protective clothing to prevent sunburn and minimize contrast between affected and unaffected skin.
- Cosmetic Camouflage: Makeup, dyes, and stains can help disguise vitiligo patches.
- Avoid Skin Trauma: Prevent cuts, abrasions, and other injuries to minimize the risk of new patches developing.
Medical Treatments
- Topical Corticosteroids: Effective for treating vitiligo on the trunk and limbs but should be used with caution due to potential side effects like skin thinning.
- Calcineurin Inhibitors: Tacrolimus and pimecrolimus are preferred for sensitive areas (face, neck, armpits) as they do not cause skin atrophy.
- Vitamin D Analogues: Often used in combination with other treatments for better efficacy.
- JAK Inhibitors: Ruxolitinib cream has shown promise in treating non-segmental vitiligo.
Phototherapy
Phototherapy involves exposing the skin to controlled UV light:
- Narrowband UVB: Effective for widespread vitiligo, often used in combination with topical treatments.
- Excimer Laser: Targets small areas, particularly useful for facial vitiligo.
Systemic Treatments
- Oral Corticosteroids: Used in short bursts to control rapid disease progression.
- Immunosuppressive Agents: Methotrexate and cyclosporine are sometimes used to stabilize active vitiligo.
Surgery may be considered for stable vitiligo:
- Skin Grafts: Transplanting healthy pigmented skin to affected areas.
- Cell Transplants: Transferring melanocyte cells to depigmented areas.
Depigmentation Therapy
For individuals with extensive vitiligo, depigmentation of remaining pigmented skin may be an option to achieve a uniform skin tone. This is a permanent treatment and involves applying a depigmenting agent over several months to remove residual pigment.
